AB1106 Depression and anxiety in paediatricsystemic lupus erythematosus. a systematic review

Abstract

Background: Depression and anxiety are common and treatable childhood mental health disorders that have been reported to impact outcomes for individuals with childhood-onset Systemic Lupus Erythematosus (cSLE)1. Research into the prevalence of depression/anxiety and cSLE comorbidity has reported conflicting results, and to our knowledge, no previous review of these data has been undertaken. Objective(s): To synthesise current knowledge regarding the association of depression and anxiety disorders with cSLE among paediatric patients. Method(s): Studies were identified through a comprehensive search of MEDLINE, EMBASE, PsychINFO, LILACS and Web Of Science (from database inception -July 2017) using MESH headings and Keywords for 'lupus erythematosus', and 'depression' or 'anxiety'. Included studies measured depression and/or anxiety symptoms prospectively among children and youth 8 to 21 years of age with a diagnosis cSLE. Data were extracted by two independent coders and where discrepancies occurred, agreement was reached by consensus. Result(s): Sixty-two studies met criteria for full text review, and of these, 13 studies were included in the final analysis. The majority (80%) of studies were of crosssectional design, with sample sizes ranging from 14 to 100 (mean=47) participants. The mean age of participants was 15.6 years and participants were predominantly female. Prevalence rates for depression ranged from 6.7% to 54%. Anxiety symptom prevalence was 20% to 34%. All studies employed self-report instruments to assess depression and anxiety; none of the studies utilised semistructured diagnostic interview to make psychiatric diagnoses. Significant heterogeneity precluded meta-analysis of the data. Conclusion(s): Depression and anxiety may be common comorbidities of cSLE however current research is limited by a paucity of studies, small sample sizes and an inability to confirm psychiatric diagnoses. Future research addressing these limitations is needed.